Systems and methods for collision avoidance using object models

ABSTRACT

Systems and methods for collision avoidance using object models are provided. In one aspect, a robotic medical system, includes a platform, one or more robotic arms coupled to the platform, a console configured to receive input commanding motion of the one or more robotic arms, a processor, and at least one computer-readable memory in communication with the processor. The processor is configured to control movement of the one or more robotic arms in a workspace based on the input received by the console, receive an indication of one or more objects are within reach of the one or more robotic arms, and update the model to include a representation of the one or more objects in the workspace.

CROSS-REFERENCE TO RELATED APPLICATION(S)

This application claims the benefit of U.S. Provisional Application No.62/906,613, filed Sep. 26, 2019, which is hereby incorporated byreference in its entirety.

TECHNICAL FIELD

The systems and methods disclosed herein are directed to surgicalrobotics, and more particularly to avoiding robotic arm collisions.

BACKGROUND

Medical procedures, such as laparoscopy, may involve accessing andvisualizing an internal region of a patient. In a laparoscopicprocedure, a medical tool can be inserted into the internal regionthrough a laparoscopic cannula.

In certain procedures, a robotically-enabled medical system may be usedto control the insertion and/or manipulation of one or more medicaltool(s). The robotically-enabled medical system may a plurality ofrobotic arms which control the medical tool(s). In positioning themedical tool(s), portions of the robotic arms may move towards anotherrobotic arm or other object in the environment, which can result incollisions between robotic arm(s) and/or other object(s).

SUMMARY

The systems, methods and devices of this disclosure each have severalinnovative aspects, no single one of which is solely responsible for thedesirable attributes disclosed herein.

In one aspect, there is provided a robotic medical system, comprising: aplatform; one or more robotic arms coupled to the platform; a consoleconfigured to receive input commanding motion of the one or more roboticarms; a processor; and at least one computer-readable memory incommunication with the processor and having stored thereon a model ofthe one or more robotic arms and computer-executable instructions tocause the processor to: control movement of the one or more robotic armsin a workspace based on the input received by the console, receive anindication of one or more objects are within reach of the one or morerobotic arms, and update the model to include a representation of theone or more objects in the workspace.

In another aspect, there is provided a robotic medical system,comprising: a platform; one or more robotic arms coupled to theplatform; a console configured to receive input commanding motion of theone or more robotic arms; a processor; and at least onecomputer-readable memory in communication with the processor and havingstored thereon a model of the one or more robotic arms, a database ofpre-modeled objects, and computer-executable instructions to cause theprocessor to: control movement of one or more robotic arms based on theinput received by the console, receive an indication of one or morepre-modeled objects being within reach of the one or more robotic arms,and update the model to include a representation of the one or morepre-modeled objects based on the indication and the database.

In yet another aspect, there is provided a robotic medical system,comprising: a platform; one or more robotic arms coupled to theplatform; a console configured to receive user input; a processor; andat least one computer-readable memory in communication with theprocessor and having stored thereon a model of the one or more roboticarms and the platform and computer-executable instructions to cause theprocessor to: receive an indication of one or more keep-out zones basedon the user input received at the console, update the model to includethe one or more keep-out zones, and prevent movement of the one or morerobotic arms into the one or more keep-out zones based on the updatedmodel.

In still yet another aspect, there is provided a robotic medical system,comprising: a platform; one or more robotic arms coupled to theplatform; one or more sensors positioned on the platform and configuredto detect one or more objects in a workspace of the robotic arms; aprocessor; and at least one computer-readable memory in communicationwith the processor and having stored thereon a model of the one or morerobotic arms and the platform and computer-executable instructions tocause the processor to: receive an indication of the one or more objectsfrom the one or more sensors, and update the model, based on theindication, to include the one or more objects within the workspace.

BRIEF DESCRIPTION OF THE DRAWINGS

The disclosed aspects will hereinafter be described in conjunction withthe appended drawings, provided to illustrate and not to limit thedisclosed aspects, wherein like designations denote like elements.

FIG. 1 illustrates an embodiment of a cart-based robotic system arrangedfor diagnostic and/or therapeutic bronchoscopy.

FIG. 2 depicts further aspects of the robotic system of FIG. 1.

FIG. 3 illustrates an embodiment of the robotic system of FIG. 1arranged for ureteroscopy.

FIG. 4 illustrates an embodiment of the robotic system of FIG. 1arranged for a vascular procedure.

FIG. 5 illustrates an embodiment of a table-based robotic systemarranged for a bronchoscopic procedure.

FIG. 6 provides an alternative view of the robotic system of FIG. 5.

FIG. 7 illustrates an example system configured to stow robotic arm(s).

FIG. 8 illustrates an embodiment of a table-based robotic systemconfigured for a ureteroscopic procedure.

FIG. 9 illustrates an embodiment of a table-based robotic systemconfigured for a laparoscopic procedure.

FIG. 10 illustrates an embodiment of the table-based robotic system ofFIGS. 5-9 with pitch or tilt adjustment.

FIG. 11 provides a detailed illustration of the interface between thetable and the column of the table-based robotic system of FIGS. 5-10.

FIG. 12 illustrates an alternative embodiment of a table-based roboticsystem.

FIG. 13 illustrates an end view of the table-based robotic system ofFIG. 12.

FIG. 14 illustrates an end view of a table-based robotic system withrobotic arms attached thereto.

FIG. 15 illustrates an exemplary instrument driver.

FIG. 16 illustrates an exemplary medical instrument with a pairedinstrument driver.

FIG. 17 illustrates an alternative design for an instrument driver andinstrument where the axes of the drive units are parallel to the axis ofthe elongated shaft of the instrument.

FIG. 18 illustrates an instrument having an instrument-based insertionarchitecture.

FIG. 19 illustrates an exemplary controller.

FIG. 20 depicts a block diagram illustrating a localization system thatestimates a location of one or more elements of the robotic systems ofFIGS. 1-10, such as the location of the instrument of FIGS. 16-18, inaccordance to an example embodiment.

FIG. 21 illustrates an example object that can be attached to a platformin accordance with aspects of this disclosure.

FIG. 22 illustrates another example object that can be attached to aplatform in accordance with aspects of this disclosure.

FIG. 23 illustrates an example robotic medical system having medicalaccessories installed thereon in accordance with aspects of thisdisclosure.

FIGS. 24A and 24B illustrate a model of a robotic system approximatedusing a geometric form in accordance with aspects of this disclosure.

FIG. 25 is a flowchart illustrating an example method operable by arobotic system, or component(s) thereof, for updating a model of arobotic medical system to include a representation of one or moreobjects in a workspace in accordance with aspects of this disclosure.

FIG. 26 is a flowchart illustrating an example method operable by arobotic system, or component(s) thereof, for preventing movement ofrobotic arm(s) using keep-out zone(s) in accordance with aspects of thisdisclosure.

FIG. 27 illustrates an example dynamic model that can be constructedfrom a light imaging, detection, and ranging (Lidar) sensor inaccordance with aspects of this disclosure.

FIGS. 28A and 28B illustrate example dynamic models that can beconstructed from a stereo camera in accordance with aspects of thisdisclosure.

FIGS. 29A and 29B illustrate an example alignment of a dynamic model toa system model in accordance with aspects of this disclosure.

DETAILED DESCRIPTION 1. Overview.

Aspects of the present disclosure may be integrated into arobotically-enabled medical system capable of performing a variety ofmedical procedures, including both minimally invasive, such aslaparoscopy, and non-invasive, such as endoscopy, procedures. Amongendoscopic procedures, the system may be capable of performingbronchoscopy, ureteroscopy, gastroscopy, etc.

In addition to performing the breadth of procedures, the system mayprovide additional benefits, such as enhanced imaging and guidance toassist the physician. Additionally, the system may provide the physicianwith the ability to perform the procedure from an ergonomic positionwithout the need for awkward arm motions and positions. Still further,the system may provide the physician with the ability to perform theprocedure with improved ease of use such that one or more of theinstruments of the system can be controlled by a single user.

Various embodiments will be described below in conjunction with thedrawings for purposes of illustration. It should be appreciated thatmany other implementations of the disclosed concepts are possible, andvarious advantages can be achieved with the disclosed implementations.Headings are included herein for reference and to aid in locatingvarious sections. These headings are not intended to limit the scope ofthe concepts described with respect thereto. Such concepts may haveapplicability throughout the entire specification.

A. Robotic System—Cart.

The robotically-enabled medical system may be configured in a variety ofways depending on the particular procedure. FIG. 1 illustrates anembodiment of a cart-based robotically-enabled system 10 arranged for adiagnostic and/or therapeutic bronchoscopy. During a bronchoscopy, thesystem 10 may comprise a cart 11 having one or more robotic arms 12 todeliver a medical instrument, such as a steerable endoscope 13, whichmay be a procedure-specific bronchoscope for bronchoscopy, to a naturalorifice access point (i.e., the mouth of the patient positioned on atable in the present example) to deliver diagnostic and/or therapeutictools. As shown, the cart 11 may be positioned proximate to thepatient's upper torso in order to provide access to the access point.Similarly, the robotic arms 12 may be actuated to position thebronchoscope relative to the access point. The arrangement in FIG. 1 mayalso be utilized when performing a gastro-intestinal (GI) procedure witha gastroscope, a specialized endoscope for GI procedures. FIG. 2 depictsan example embodiment of the cart in greater detail.

With continued reference to FIG. 1, once the cart 11 is properlypositioned, the robotic arms 12 may insert the steerable endoscope 13into the patient robotically, manually, or a combination thereof. Asshown, the steerable endoscope 13 may comprise at least two telescopingparts, such as an inner leader portion and an outer sheath portion, eachportion coupled to a separate instrument driver from the set ofinstrument drivers 28, each instrument driver coupled to the distal endof an individual robotic arm. This linear arrangement of the instrumentdrivers 28, which facilitates coaxially aligning the leader portion withthe sheath portion, creates a “virtual rail” 29 that may be repositionedin space by manipulating the one or more robotic arms 12 into differentangles and/or positions. The virtual rails described herein are depictedin the Figures using dashed lines, and accordingly the dashed lines donot depict any physical structure of the system. Translation of theinstrument drivers 28 along the virtual rail 29 telescopes the innerleader portion relative to the outer sheath portion or advances orretracts the endoscope 13 from the patient. The angle of the virtualrail 29 may be adjusted, translated, and pivoted based on clinicalapplication or physician preference. For example, in bronchoscopy, theangle and position of the virtual rail 29 as shown represents acompromise between providing physician access to the endoscope 13 whileminimizing friction that results from bending the endoscope 13 into thepatient's mouth.

The endoscope 13 may be directed down the patient's trachea and lungsafter insertion using precise commands from the robotic system untilreaching the target destination or operative site. In order to enhancenavigation through the patient's lung network and/or reach the desiredtarget, the endoscope 13 may be manipulated to telescopically extend theinner leader portion from the outer sheath portion to obtain enhancedarticulation and greater bend radius. The use of separate instrumentdrivers 28 also allows the leader portion and sheath portion to bedriven independently of each other.

For example, the endoscope 13 may be directed to deliver a biopsy needleto a target, such as, for example, a lesion or nodule within the lungsof a patient. The needle may be deployed down a working channel thatruns the length of the endoscope to obtain a tissue sample to beanalyzed by a pathologist. Depending on the pathology results,additional tools may be deployed down the working channel of theendoscope for additional biopsies. After identifying a nodule to bemalignant, the endoscope 13 may endoscopically deliver tools to resectthe potentially cancerous tissue. In some instances, diagnostic andtherapeutic treatments can be delivered in separate procedures. In thosecircumstances, the endoscope 13 may also be used to deliver a fiducialto “mark” the location of the target nodule as well. In other instances,diagnostic and therapeutic treatments may be delivered during the sameprocedure.

The system 10 may also include a movable tower 30, which may beconnected via support cables to the cart 11 to provide support forcontrols, electronics, fluidics, optics, sensors, and/or power to thecart 11. Placing such functionality in the tower 30 allows for a smallerform factor cart 11 that may be more easily adjusted and/or repositionedby an operating physician and his/her staff. Additionally, the divisionof functionality between the cart/table and the support tower 30 reducesoperating room clutter and facilitates improving clinical workflow.While the cart 11 may be positioned close to the patient, the tower 30may be stowed in a remote location to stay out of the way during aprocedure.

In support of the robotic systems described above, the tower 30 mayinclude component(s) of a computer-based control system that storescomputer program instructions, for example, within a non-transitorycomputer-readable storage medium such as a persistent magnetic storagedrive, solid state drive, etc. The execution of those instructions,whether the execution occurs in the tower 30 or the cart 11, may controlthe entire system or sub-system(s) thereof. For example, when executedby a processor of the computer system, the instructions may cause thecomponents of the robotics system to actuate the relevant carriages andarm mounts, actuate the robotics arms, and control the medicalinstruments. For example, in response to receiving the control signal,the motors in the joints of the robotics arms may position the arms intoa certain posture.

The tower 30 may also include a pump, flow meter, valve control, and/orfluid access in order to provide controlled irrigation and aspirationcapabilities to the system that may be deployed through the endoscope13. These components may also be controlled using the computer system ofthe tower 30. In some embodiments, irrigation and aspirationcapabilities may be delivered directly to the endoscope 13 throughseparate cable(s).

The tower 30 may include a voltage and surge protector designed toprovide filtered and protected electrical power to the cart 11, therebyavoiding placement of a power transformer and other auxiliary powercomponents in the cart 11, resulting in a smaller, more moveable cart11.

The tower 30 may also include support equipment for the sensors deployedthroughout the robotic system 10. For example, the tower 30 may includeoptoelectronics equipment for detecting, receiving, and processing datareceived from the optical sensors or cameras throughout the roboticsystem 10. In combination with the control system, such optoelectronicsequipment may be used to generate real-time images for display in anynumber of consoles deployed throughout the system, including in thetower 30. Similarly, the tower 30 may also include an electronicsubsystem for receiving and processing signals received from deployedelectromagnetic (EM) sensors. The tower 30 may also be used to house andposition an EM field generator for detection by EM sensors in or on themedical instrument.

The tower 30 may also include a console 31 in addition to other consolesavailable in the rest of the system, e.g., console mounted on top of thecart. The console 31 may include a user interface and a display screen,such as a touchscreen, for the physician operator. Consoles in thesystem 10 are generally designed to provide both robotic controls aswell as preoperative and real-time information of the procedure, such asnavigational and localization information of the endoscope 13. When theconsole 31 is not the only console available to the physician, it may beused by a second operator, such as a nurse, to monitor the health orvitals of the patient and the operation of the system 10, as well as toprovide procedure-specific data, such as navigational and localizationinformation. In other embodiments, the console 30 is housed in a bodythat is separate from the tower 30.

The tower 30 may be coupled to the cart 11 and endoscope 13 through oneor more cables or connections (not shown). In some embodiments, thesupport functionality from the tower 30 may be provided through a singlecable to the cart 11, simplifying and de-cluttering the operating room.In other embodiments, specific functionality may be coupled in separatecabling and connections. For example, while power may be providedthrough a single power cable to the cart 11, the support for controls,optics, fluidics, and/or navigation may be provided through a separatecable.

FIG. 2 provides a detailed illustration of an embodiment of the cart 11from the cart-based robotically-enabled system shown in FIG. 1. The cart11 generally includes an elongated support structure 14 (often referredto as a “column”), a cart base 15, and a console 16 at the top of thecolumn 14. The column 14 may include one or more carriages, such as acarriage 17 (alternatively “arm support”) for supporting the deploymentof one or more robotic arms 12 (three shown in FIG. 2). The carriage 17may include individually configurable arm mounts that rotate along aperpendicular axis to adjust the base of the robotic arms 12 for betterpositioning relative to the patient. The carriage 17 also includes acarriage interface 19 that allows the carriage 17 to verticallytranslate along the column 14.

The carriage interface 19 is connected to the column 14 through slots,such as slot 20, that are positioned on opposite sides of the column 14to guide the vertical translation of the carriage 17. The slot 20contains a vertical translation interface to position and hold thecarriage 17 at various vertical heights relative to the cart base 15.Vertical translation of the carriage 17 allows the cart 11 to adjust thereach of the robotic arms 12 to meet a variety of table heights, patientsizes, and physician preferences. Similarly, the individuallyconfigurable arm mounts on the carriage 17 allow the robotic arm base 21of the robotic arms 12 to be angled in a variety of configurations.

In some embodiments, the slot 20 may be supplemented with slot coversthat are flush and parallel to the slot surface to prevent dirt andfluid ingress into the internal chambers of the column 14 and thevertical translation interface as the carriage 17 vertically translates.The slot covers may be deployed through pairs of spring spoolspositioned near the vertical top and bottom of the slot 20. The coversare coiled within the spools until deployed to extend and retract fromtheir coiled state as the carriage 17 vertically translates up and down.The spring-loading of the spools provides force to retract the coverinto a spool when the carriage 17 translates towards the spool, whilealso maintaining a tight seal when the carriage 17 translates away fromthe spool. The covers may be connected to the carriage 17 using, forexample, brackets in the carriage interface 19 to ensure properextension and retraction of the cover as the carriage 17 translates.

The column 14 may internally comprise mechanisms, such as gears andmotors, that are designed to use a vertically aligned lead screw totranslate the carriage 17 in a mechanized fashion in response to controlsignals generated in response to user inputs, e.g., inputs from theconsole 16.

The robotic arms 12 may generally comprise robotic arm bases 21 and endeffectors 22, separated by a series of linkages 23 that are connected bya series of joints 24, each joint comprising an independent actuator,each actuator comprising an independently controllable motor. Eachindependently controllable joint represents an independentdegree-of-freedom (DoF) available to the robotic arm 12. Each of therobotic arms 12 may have seven joints, and thus provide seven degrees offreedom. A multitude of joints result in a multitude of degrees offreedom, allowing for “redundant” degrees of freedom. Having redundantdegrees of freedom allows the robotic arms 12 to position theirrespective end effectors 22 at a specific position, orientation, andtrajectory in space using different linkage positions and joint angles.This allows for the system to position and direct a medical instrumentfrom a desired point in space while allowing the physician to move thearm joints into a clinically advantageous position away from the patientto create greater access, while avoiding arm collisions.

The cart base 15 balances the weight of the column 14, carriage 17, androbotic arms 12 over the floor. Accordingly, the cart base 15 housesheavier components, such as electronics, motors, power supply, as wellas components that either enable movement and/or immobilize the cart 11.For example, the cart base 15 includes rollable wheel-shaped casters 25that allow for the cart 11 to easily move around the room prior to aprocedure. After reaching the appropriate position, the casters 25 maybe immobilized using wheel locks to hold the cart 11 in place during theprocedure.

Positioned at the vertical end of the column 14, the console 16 allowsfor both a user interface for receiving user input and a display screen(or a dual-purpose device such as, for example, a touchscreen 26) toprovide the physician user with both preoperative and intraoperativedata. Potential preoperative data on the touchscreen 26 may includepreoperative plans, navigation and mapping data derived frompreoperative computerized tomography (CT) scans, and/or notes frompreoperative patient interviews. Intraoperative data on display mayinclude optical information provided from the tool, sensor andcoordinate information from sensors, as well as vital patientstatistics, such as respiration, heart rate, and/or pulse. The console16 may be positioned and tilted to allow a physician to access theconsole 16 from the side of the column 14 opposite the carriage 17. Fromthis position, the physician may view the console 16, robotic arms 12,and patient while operating the console 16 from behind the cart 11. Asshown, the console 16 also includes a handle 27 to assist withmaneuvering and stabilizing the cart 11.

FIG. 3 illustrates an embodiment of a robotically-enabled system 10arranged for ureteroscopy. In a ureteroscopic procedure, the cart 11 maybe positioned to deliver a ureteroscope 32, a procedure-specificendoscope designed to traverse a patient's urethra and ureter, to thelower abdominal area of the patient. In a ureteroscopy, it may bedesirable for the ureteroscope 32 to be directly aligned with thepatient's urethra to reduce friction and forces on the sensitive anatomyin the area. As shown, the cart 11 may be aligned at the foot of thetable to allow the robotic arms 12 to position the ureteroscope 32 fordirect linear access to the patient's urethra. From the foot of thetable, the robotic arms 12 may insert the ureteroscope 32 along thevirtual rail 33 directly into the patient's lower abdomen through theurethra.

After insertion into the urethra, using similar control techniques as inbronchoscopy, the ureteroscope 32 may be navigated into the bladder,ureters, and/or kidneys for diagnostic and/or therapeutic applications.For example, the ureteroscope 32 may be directed into the ureter andkidneys to break up kidney stone build up using a laser or ultrasoniclithotripsy device deployed down the working channel of the ureteroscope32. After lithotripsy is complete, the resulting stone fragments may beremoved using baskets deployed down the ureteroscope 32.

FIG. 4 illustrates an embodiment of a robotically-enabled system 10similarly arranged for a vascular procedure. In a vascular procedure,the system 10 may be configured such that the cart 11 may deliver amedical instrument 34, such as a steerable catheter, to an access pointin the femoral artery in the patient's leg. The femoral artery presentsboth a larger diameter for navigation as well as a relatively lesscircuitous and tortuous path to the patient's heart, which simplifiesnavigation. As in a ureteroscopic procedure, the cart 11 may bepositioned towards the patient's legs and lower abdomen to allow therobotic arms 12 to provide a virtual rail 35 with direct linear accessto the femoral artery access point in the patient's thigh/hip region.After insertion into the artery, the medical instrument 34 may bedirected and inserted by translating the instrument drivers 28.Alternatively, the cart may be positioned around the patient's upperabdomen in order to reach alternative vascular access points, such as,for example, the carotid and brachial arteries near the shoulder andwrist.

B. Robotic System—Table.

Embodiments of the robotically-enabled medical system may alsoincorporate the patient's table. Incorporation of the table reduces theamount of capital equipment within the operating room by removing thecart, which allows greater access to the patient. FIG. 5 illustrates anembodiment of such a robotically-enabled system arranged for abronchoscopic procedure. System 36 includes a support structure orcolumn 37 for supporting platform 38 (shown as a “table” or “bed”) overthe floor. Much like in the cart-based systems, the end effectors of therobotic arms 39 of the system 36 comprise instrument drivers 42 that aredesigned to manipulate an elongated medical instrument, such as abronchoscope 40 in FIG. 5, through or along a virtual rail 41 formedfrom the linear alignment of the instrument drivers 42. In practice, aC-arm for providing fluoroscopic imaging may be positioned over thepatient's upper abdominal area by placing the emitter and detectoraround the table 38.

FIG. 6 provides an alternative view of the system 36 without the patientand medical instrument for discussion purposes. As shown, the column 37may include one or more carriages 43 shown as ring-shaped in the system36, from which the one or more robotic arms 39 may be based. Thecarriages 43 may translate along a vertical column interface 44 thatruns the length of the column 37 to provide different vantage pointsfrom which the robotic arms 39 may be positioned to reach the patient.The carriage(s) 43 may rotate around the column 37 using a mechanicalmotor positioned within the column 37 to allow the robotic arms 39 tohave access to multiples sides of the table 38, such as, for example,both sides of the patient. In embodiments with multiple carriages, thecarriages may be individually positioned on the column and may translateand/or rotate independently of the other carriages. While the carriages43 need not surround the column 37 or even be circular, the ring-shapeas shown facilitates rotation of the carriages 43 around the column 37while maintaining structural balance. Rotation and translation of thecarriages 43 allows the system 36 to align the medical instruments, suchas endoscopes and laparoscopes, into different access points on thepatient. In other embodiments (not shown), the system 36 can include apatient table or bed with adjustable arm supports in the form of bars orrails extending alongside it. One or more robotic arms 39 (e.g., via ashoulder with an elbow joint) can be attached to the adjustable armsupports, which can be vertically adjusted. By providing verticaladjustment, the robotic arms 39 are advantageously capable of beingstowed compactly beneath the patient table or bed, and subsequentlyraised during a procedure.

The robotic arms 39 may be mounted on the carriages 43 through a set ofarm mounts 45 comprising a series of joints that may individually rotateand/or telescopically extend to provide additional configurability tothe robotic arms 39. Additionally, the arm mounts 45 may be positionedon the carriages 43 such that, when the carriages 43 are appropriatelyrotated, the arm mounts 45 may be positioned on either the same side ofthe table 38 (as shown in FIG. 6), on opposite sides of the table 38 (asshown in FIG. 9), or on adjacent sides of the table 38 (not shown).

The column 37 structurally provides support for the table 38, and a pathfor vertical translation of the carriages 43. Internally, the column 37may be equipped with lead screws for guiding vertical translation of thecarriages, and motors to mechanize the translation of the carriages 43based the lead screws. The column 37 may also convey power and controlsignals to the carriages 43 and the robotic arms 39 mounted thereon.

The table base 46 serves a similar function as the cart base 15 in thecart 11 shown in FIG. 2, housing heavier components to balance thetable/bed 38, the column 37, the carriages 43, and the robotic arms 39.The table base 46 may also incorporate rigid casters to providestability during procedures. Deployed from the bottom of the table base46, the casters may extend in opposite directions on both sides of thebase 46 and retract when the system 36 needs to be moved.

With continued reference to FIG. 6, the system 36 may also include atower (not shown) that divides the functionality of the system 36between the table and the tower to reduce the form factor and bulk ofthe table. As in earlier disclosed embodiments, the tower may provide avariety of support functionalities to the table, such as processing,computing, and control capabilities, power, fluidics, and/or optical andsensor processing. The tower may also be movable to be positioned awayfrom the patient to improve physician access and de-clutter theoperating room. Additionally, placing components in the tower allows formore storage space in the table base 46 for potential stowage of therobotic arms 39. The tower may also include a master controller orconsole that provides both a user interface for user input, such askeyboard and/or pendant, as well as a display screen (or touchscreen)for preoperative and intraoperative information, such as real-timeimaging, navigation, and tracking information. In some embodiments, thetower may also contain holders for gas tanks to be used forinsufflation.

In some embodiments, a table base may stow and store the robotic armswhen not in use. FIG. 7 illustrates a system 47 that stows robotic armsin an embodiment of the table-based system. In the system 47, carriages48 may be vertically translated into base 49 to stow robotic arms 50,arm mounts 51, and the carriages 48 within the base 49. Base covers 52may be translated and retracted open to deploy the carriages 48, armmounts 51, and robotic arms 50 around column 53, and closed to stow toprotect them when not in use. The base covers 52 may be sealed with amembrane 54 along the edges of its opening to prevent dirt and fluidingress when closed.

FIG. 8 illustrates an embodiment of a robotically-enabled table-basedsystem configured for a ureteroscopic procedure. In a ureteroscopy, thetable 38 may include a swivel portion 55 for positioning a patientoff-angle from the column 37 and table base 46. The swivel portion 55may rotate or pivot around a pivot point (e.g., located below thepatient's head) in order to position the bottom portion of the swivelportion 55 away from the column 37. For example, the pivoting of theswivel portion 55 allows a C-arm (not shown) to be positioned over thepatient's lower abdomen without competing for space with the column (notshown) below table 38. By rotating the carriage 35 (not shown) aroundthe column 37, the robotic arms 39 may directly insert a ureteroscope 56along a virtual rail 57 into the patient's groin area to reach theurethra. In a ureteroscopy, stirrups 58 may also be fixed to the swivelportion 55 of the table 38 to support the position of the patient's legsduring the procedure and allow clear access to the patient's groin area.

In a laparoscopic procedure, through small incision(s) in the patient'sabdominal wall, minimally invasive instruments may be inserted into thepatient's anatomy. In some embodiments, the minimally invasiveinstruments comprise an elongated rigid member, such as a shaft, whichis used to access anatomy within the patient. After inflation of thepatient's abdominal cavity, the instruments may be directed to performsurgical or medical tasks, such as grasping, cutting, ablating,suturing, etc. In some embodiments, the instruments can comprise ascope, such as a laparoscope. FIG. 9 illustrates an embodiment of arobotically-enabled table-based system configured for a laparoscopicprocedure. As shown in FIG. 9, the carriages 43 of the system 36 may berotated and vertically adjusted to position pairs of the robotic arms 39on opposite sides of the table 38, such that instrument 59 may bepositioned using the arm mounts 45 to be passed through minimalincisions on both sides of the patient to reach his/her abdominalcavity.

To accommodate laparoscopic procedures, the robotically-enabled tablesystem may also tilt the platform to a desired angle. FIG. 10illustrates an embodiment of the robotically-enabled medical system withpitch or tilt adjustment. As shown in FIG. 10, the system 36 mayaccommodate tilt of the table 38 to position one portion of the table ata greater distance from the floor than the other. Additionally, the armmounts 45 may rotate to match the tilt such that the robotic arms 39maintain the same planar relationship with the table 38. To accommodatesteeper angles, the column 37 may also include telescoping portions 60that allow vertical extension of the column 37 to keep the table 38 fromtouching the floor or colliding with the table base 46.

FIG. 11 provides a detailed illustration of the interface between thetable 38 and the column 37. Pitch rotation mechanism 61 may beconfigured to alter the pitch angle of the table 38 relative to thecolumn 37 in multiple degrees of freedom. The pitch rotation mechanism61 may be enabled by the positioning of orthogonal axes 1, 2 at thecolumn-table interface, each axis actuated by a separate motor 3, 4responsive to an electrical pitch angle command. Rotation along onescrew 5 would enable tilt adjustments in one axis 1, while rotationalong the other screw 6 would enable tilt adjustments along the otheraxis 2. In some embodiments, a ball joint can be used to alter the pitchangle of the table 38 relative to the column 37 in multiple degrees offreedom.

For example, pitch adjustments are particularly useful when trying toposition the table in a Trendelenburg position, i.e., position thepatient's lower abdomen at a higher position from the floor than thepatient's upper abdomen, for lower abdominal surgery. The Trendelenburgposition causes the patient's internal organs to slide towards his/herupper abdomen through the force of gravity, clearing out the abdominalcavity for minimally invasive tools to enter and perform lower abdominalsurgical or medical procedures, such as laparoscopic prostatectomy.

FIGS. 12 and 13 illustrate isometric and end views of an alternativeembodiment of a table-based surgical robotics system 100. The surgicalrobotics system 100 includes one or more adjustable arm supports 105that can be configured to support one or more robotic arms (see, forexample, FIG. 14) relative to a table 101. In the illustratedembodiment, a single adjustable arm support 105 is shown, though anadditional arm support can be provided on an opposite side of the table101. The adjustable arm support 105 can be configured so that it canmove relative to the table 101 to adjust and/or vary the position of theadjustable arm support 105 and/or any robotic arms mounted theretorelative to the table 101. For example, the adjustable arm support 105may be adjusted one or more degrees of freedom relative to the table101. The adjustable arm support 105 provides high versatility to thesystem 100, including the ability to easily stow the one or moreadjustable arm supports 105 and any robotics arms attached theretobeneath the table 101. The adjustable arm support 105 can be elevatedfrom the stowed position to a position below an upper surface of thetable 101. In other embodiments, the adjustable arm support 105 can beelevated from the stowed position to a position above an upper surfaceof the table 101.

The adjustable arm support 105 can provide several degrees of freedom,including lift, lateral translation, tilt, etc. In the illustratedembodiment of FIGS. 12 and 13, the arm support 105 is configured withfour degrees of freedom, which are illustrated with arrows in FIG. 12. Afirst degree of freedom allows for adjustment of the adjustable armsupport 105 in the z-direction (“Z-lift”). For example, the adjustablearm support 105 can include a carriage 109 configured to move up or downalong or relative to a column 102 supporting the table 101. A seconddegree of freedom can allow the adjustable arm support 105 to tilt. Forexample, the adjustable arm support 105 can include a rotary joint,which can allow the adjustable arm support 105 to be aligned with thebed in a Trendelenburg position. A third degree of freedom can allow theadjustable arm support 105 to “pivot up,” which can be used to adjust adistance between a side of the table 101 and the adjustable arm support105. A fourth degree of freedom can permit translation of the adjustablearm support 105 along a longitudinal length of the table.

The surgical robotics system 100 in FIGS. 12 and 13 can comprise a tablesupported by a column 102 that is mounted to a base 103. The base 103and the column 102 support the table 101 relative to a support surface.A floor axis 131 and a support axis 133 are shown in FIG. 13.

The adjustable arm support 105 can be mounted to the column 102. Inother embodiments, the arm support 105 can be mounted to the table 101or base 103. The adjustable arm support 105 can include a carriage 109,a bar or rail connector 111 and a bar or rail 107. In some embodiments,one or more robotic arms mounted to the rail 107 can translate and moverelative to one another.

The carriage 109 can be attached to the column 102 by a first joint 113,which allows the carriage 109 to move relative to the column 102 (e.g.,such as up and down a first or vertical axis 123). The first joint 113can provide the first degree of freedom (“Z-lift”) to the adjustable armsupport 105. The adjustable arm support 105 can include a second joint115, which provides the second degree of freedom (tilt) for theadjustable arm support 105. The adjustable arm support 105 can include athird joint 117, which can provide the third degree of freedom (“pivotup”) for the adjustable arm support 105. An additional joint 119 (shownin FIG. 13) can be provided that mechanically constrains the third joint117 to maintain an orientation of the rail 107 as the rail connector 111is rotated about a third axis 127. The adjustable arm support 105 caninclude a fourth joint 121, which can provide a fourth degree of freedom(translation) for the adjustable arm support 105 along a fourth axis129.

FIG. 14 illustrates an end view of the surgical robotics system 140Awith two adjustable arm supports 105A, 105B mounted on opposite sides ofa table 101. A first robotic arm 142A is attached to the bar or rail107A of the first adjustable arm support 105B. The first robotic arm142A includes a base 144A attached to the rail 107A. The distal end ofthe first robotic arm 142A includes an instrument drive mechanism 146Athat can attach to one or more robotic medical instruments or tools.Similarly, the second robotic arm 142B includes a base 144B attached tothe rail 107B. The distal end of the second robotic arm 142B includes aninstrument drive mechanism 146B. The instrument drive mechanism 146B canbe configured to attach to one or more robotic medical instruments ortools.

In some embodiments, one or more of the robotic arms 142A, 142Bcomprises an arm with seven or more degrees of freedom. In someembodiments, one or more of the robotic arms 142A, 142B can includeeight degrees of freedom, including an insertion axis (1-degree offreedom including insertion), a wrist (3-degrees of freedom includingwrist pitch, yaw and roll), an elbow (1-degree of freedom includingelbow pitch), a shoulder (2-degrees of freedom including shoulder pitchand yaw), and base 144A, 144B (1-degree of freedom includingtranslation). In some embodiments, the insertion degree of freedom canbe provided by the robotic arm 142A, 142B, while in other embodiments,the instrument itself provides insertion via an instrument-basedinsertion architecture.

C. Instrument Driver & Interface.

The end effectors of the system's robotic arms may comprise (i) aninstrument driver (alternatively referred to as “instrument drivemechanism” or “instrument device manipulator”) that incorporateselectro-mechanical means for actuating the medical instrument and (ii) aremovable or detachable medical instrument, which may be devoid of anyelectro-mechanical components, such as motors. This dichotomy may bedriven by the need to sterilize medical instruments used in medicalprocedures, and the inability to adequately sterilize expensive capitalequipment due to their intricate mechanical assemblies and sensitiveelectronics. Accordingly, the medical instruments may be designed to bedetached, removed, and interchanged from the instrument driver (and thusthe system) for individual sterilization or disposal by the physician orthe physician's staff. In contrast, the instrument drivers need not bechanged or sterilized, and may be draped for protection.

FIG. 15 illustrates an example instrument driver. Positioned at thedistal end of a robotic arm, instrument driver 62 comprises one or moredrive units 63 arranged with parallel axes to provide controlled torqueto a medical instrument via drive shafts 64. Each drive unit 63comprises an individual drive shaft 64 for interacting with theinstrument, a gear head 65 for converting the motor shaft rotation to adesired torque, a motor 66 for generating the drive torque, an encoder67 to measure the speed of the motor shaft and provide feedback to thecontrol circuitry, and control circuitry 68 for receiving controlsignals and actuating the drive unit. Each drive unit 63 beingindependently controlled and motorized, the instrument driver 62 mayprovide multiple (e.g., four as shown in FIG. 15) independent driveoutputs to the medical instrument. In operation, the control circuitry68 would receive a control signal, transmit a motor signal to the motor66, compare the resulting motor speed as measured by the encoder 67 withthe desired speed, and modulate the motor signal to generate the desiredtorque.

For procedures that require a sterile environment, the robotic systemmay incorporate a drive interface, such as a sterile adapter connectedto a sterile drape, that sits between the instrument driver and themedical instrument. The chief purpose of the sterile adapter is totransfer angular motion from the drive shafts of the instrument driverto the drive inputs of the instrument while maintaining physicalseparation, and thus sterility, between the drive shafts and driveinputs. Accordingly, an example sterile adapter may comprise a series ofrotational inputs and outputs intended to be mated with the drive shaftsof the instrument driver and drive inputs on the instrument. Connectedto the sterile adapter, the sterile drape, comprised of a thin, flexiblematerial such as transparent or translucent plastic, is designed tocover the capital equipment, such as the instrument driver, robotic arm,and cart (in a cart-based system) or table (in a table-based system).Use of the drape would allow the capital equipment to be positionedproximate to the patient while still being located in an area notrequiring sterilization (i.e., non-sterile field). On the other side ofthe sterile drape, the medical instrument may interface with the patientin an area requiring sterilization (i.e., sterile field).

D. Medical Instrument.

FIG. 16 illustrates an example medical instrument with a pairedinstrument driver. Like other instruments designed for use with arobotic system, medical instrument 70 comprises an elongated shaft 71(or elongate body) and an instrument base 72. The instrument base 72,also referred to as an “instrument handle” due to its intended designfor manual interaction by the physician, may generally compriserotatable drive inputs 73, e.g., receptacles, pulleys or spools, thatare designed to be mated with drive outputs 74 that extend through adrive interface on instrument driver 75 at the distal end of robotic arm76. When physically connected, latched, and/or coupled, the mated driveinputs 73 of the instrument base 72 may share axes of rotation with thedrive outputs 74 in the instrument driver 75 to allow the transfer oftorque from the drive outputs 74 to the drive inputs 73. In someembodiments, the drive outputs 74 may comprise splines that are designedto mate with receptacles on the drive inputs 73.

The elongated shaft 71 is designed to be delivered through either ananatomical opening or lumen, e.g., as in endoscopy, or a minimallyinvasive incision, e.g., as in laparoscopy. The elongated shaft 71 maybe either flexible (e.g., having properties similar to an endoscope) orrigid (e.g., having properties similar to a laparoscope) or contain acustomized combination of both flexible and rigid portions. Whendesigned for laparoscopy, the distal end of a rigid elongated shaft maybe connected to an end effector extending from a jointed wrist formedfrom a clevis with at least one degree of freedom and a surgical tool ormedical instrument, such as, for example, a grasper or scissors, thatmay be actuated based on force from the tendons as the drive inputsrotate in response to torque received from the drive outputs 74 of theinstrument driver 75. When designed for endoscopy, the distal end of aflexible elongated shaft may include a steerable or controllable bendingsection that may be articulated and bent based on torque received fromthe drive outputs 74 of the instrument driver 75.

Torque from the instrument driver 75 is transmitted down the elongatedshaft 71 using tendons along the elongated shaft 71. These individualtendons, such as pull wires, may be individually anchored to individualdrive inputs 73 within the instrument handle 72. From the handle 72, thetendons are directed down one or more pull lumens along the elongatedshaft 71 and anchored at the distal portion of the elongated shaft 71,or in the wrist at the distal portion of the elongated shaft. During asurgical procedure, such as a laparoscopic, endoscopic or hybridprocedure, these tendons may be coupled to a distally mounted endeffector, such as a wrist, grasper, or scissor. Under such anarrangement, torque exerted on drive inputs 73 would transfer tension tothe tendon, thereby causing the end effector to actuate in some way. Insome embodiments, during a surgical procedure, the tendon may cause ajoint to rotate about an axis, thereby causing the end effector to movein one direction or another. Alternatively, the tendon may be connectedto one or more jaws of a grasper at the distal end of the elongatedshaft 71, where tension from the tendon causes the grasper to close.

In endoscopy, the tendons may be coupled to a bending or articulatingsection positioned along the elongated shaft 71 (e.g., at the distalend) via adhesive, control ring, or other mechanical fixation. Whenfixedly attached to the distal end of a bending section, torque exertedon the drive inputs 73 would be transmitted down the tendons, causingthe softer, bending section (sometimes referred to as the articulablesection or region) to bend or articulate. Along the non-bendingsections, it may be advantageous to spiral or helix the individual pulllumens that direct the individual tendons along (or inside) the walls ofthe endoscope shaft to balance the radial forces that result fromtension in the pull wires. The angle of the spiraling and/or spacingtherebetween may be altered or engineered for specific purposes, whereintighter spiraling exhibits lesser shaft compression under load forces,while lower amounts of spiraling results in greater shaft compressionunder load forces, but limits bending. On the other end of the spectrum,the pull lumens may be directed parallel to the longitudinal axis of theelongated shaft 71 to allow for controlled articulation in the desiredbending or articulable sections.

In endoscopy, the elongated shaft 71 houses a number of components toassist with the robotic procedure. The shaft 71 may comprise a workingchannel for deploying surgical tools (or medical instruments),irrigation, and/or aspiration to the operative region at the distal endof the shaft 71. The shaft 71 may also accommodate wires and/or opticalfibers to transfer signals to/from an optical assembly at the distaltip, which may include an optical camera. The shaft 71 may alsoaccommodate optical fibers to carry light from proximally-located lightsources, such as light emitting diodes, to the distal end of the shaft71.

At the distal end of the instrument 70, the distal tip may also comprisethe opening of a working channel for delivering tools for diagnosticand/or therapy, irrigation, and aspiration to an operative site. Thedistal tip may also include a port for a camera, such as a fiberscope ora digital camera, to capture images of an internal anatomical space.Relatedly, the distal tip may also include ports for light sources forilluminating the anatomical space when using the camera.

In the example of FIG. 16, the drive shaft axes, and thus the driveinput axes, are orthogonal to the axis of the elongated shaft 71. Thisarrangement, however, complicates roll capabilities for the elongatedshaft 71. Rolling the elongated shaft 71 along its axis while keepingthe drive inputs 73 static results in undesirable tangling of thetendons as they extend off the drive inputs 73 and enter pull lumenswithin the elongated shaft 71. The resulting entanglement of suchtendons may disrupt any control algorithms intended to predict movementof the flexible elongated shaft 71 during an endoscopic procedure.

FIG. 17 illustrates an alternative design for an instrument driver andinstrument where the axes of the drive units are parallel to the axis ofthe elongated shaft of the instrument. As shown, a circular instrumentdriver 80 comprises four drive units with their drive outputs 81 alignedin parallel at the end of a robotic arm 82. The drive units, and theirrespective drive outputs 81, are housed in a rotational assembly 83 ofthe instrument driver 80 that is driven by one of the drive units withinthe assembly 83. In response to torque provided by the rotational driveunit, the rotational assembly 83 rotates along a circular bearing thatconnects the rotational assembly 83 to the non-rotational portion 84 ofthe instrument driver 80. Power and controls signals may be communicatedfrom the non-rotational portion 84 of the instrument driver 80 to therotational assembly 83 through electrical contacts that may bemaintained through rotation by a brushed slip ring connection (notshown). In other embodiments, the rotational assembly 83 may beresponsive to a separate drive unit that is integrated into thenon-rotatable portion 84, and thus not in parallel to the other driveunits. The rotational mechanism 83 allows the instrument driver 80 torotate the drive units, and their respective drive outputs 81, as asingle unit around an instrument driver axis 85.

Like earlier disclosed embodiments, an instrument 86 may comprise anelongated shaft portion 88 and an instrument base 87 (shown with atransparent external skin for discussion purposes) comprising aplurality of drive inputs 89 (such as receptacles, pulleys, and spools)that are configured to receive the drive outputs 81 in the instrumentdriver 80. Unlike prior disclosed embodiments, the instrument shaft 88extends from the center of the instrument base 87 with an axissubstantially parallel to the axes of the drive inputs 89, rather thanorthogonal as in the design of FIG. 16.

When coupled to the rotational assembly 83 of the instrument driver 80,the medical instrument 86, comprising instrument base 87 and instrumentshaft 88, rotates in combination with the rotational assembly 83 aboutthe instrument driver axis 85. Since the instrument shaft 88 ispositioned at the center of instrument base 87, the instrument shaft 88is coaxial with instrument driver axis 85 when attached. Thus, rotationof the rotational assembly 83 causes the instrument shaft 88 to rotateabout its own longitudinal axis. Moreover, as the instrument base 87rotates with the instrument shaft 88, any tendons connected to the driveinputs 89 in the instrument base 87 are not tangled during rotation.Accordingly, the parallelism of the axes of the drive outputs 81, driveinputs 89, and instrument shaft 88 allows for the shaft rotation withouttangling any control tendons.

FIG. 18 illustrates an instrument having an instrument based insertionarchitecture in accordance with some embodiments. The instrument 150 canbe coupled to any of the instrument drivers discussed above. Theinstrument 150 comprises an elongated shaft 152, an end effector 162connected to the shaft 152, and a handle 170 coupled to the shaft 152.The elongated shaft 152 comprises a tubular member having a proximalportion 154 and a distal portion 156. The elongated shaft 152 comprisesone or more channels or grooves 158 along its outer surface. The grooves158 are configured to receive one or more wires or cables 180therethrough. One or more cables 180 thus run along an outer surface ofthe elongated shaft 152. In other embodiments, cables 180 can also runthrough the elongated shaft 152. Manipulation of the one or more cables180 (e.g., via an instrument driver) results in actuation of the endeffector 162.

The instrument handle 170, which may also be referred to as aninstrument base, may generally comprise an attachment interface 172having one or more mechanical inputs 174, e.g., receptacles, pulleys orspools, that are designed to be reciprocally mated with one or moretorque couplers on an attachment surface of an instrument driver.

In some embodiments, the instrument 150 comprises a series of pulleys orcables that enable the elongated shaft 152 to translate relative to thehandle 170. In other words, the instrument 150 itself comprises aninstrument-based insertion architecture that accommodates insertion ofthe instrument, thereby minimizing the reliance on a robot arm toprovide insertion of the instrument 150. In other embodiments, a roboticarm can be largely responsible for instrument insertion.

E. Controller.

Any of the robotic systems described herein can include an input deviceor controller for manipulating an instrument attached to a robotic arm.In some embodiments, the controller can be coupled (e.g.,communicatively, electronically, electrically, wirelessly and/ormechanically) with an instrument such that manipulation of thecontroller causes a corresponding manipulation of the instrument e.g.,via master slave control.

FIG. 19 is a perspective view of an embodiment of a controller 182. Inthe present embodiment, the controller 182 comprises a hybrid controllerthat can have both impedance and admittance control. In otherembodiments, the controller 182 can utilize just impedance or passivecontrol. In other embodiments, the controller 182 can utilize justadmittance control. By being a hybrid controller, the controller 182advantageously can have a lower perceived inertia while in use.

In the illustrated embodiment, the controller 182 is configured to allowmanipulation of two medical instruments, and includes two handles 184.Each of the handles 184 is connected to a gimbal 186. Each gimbal 186 isconnected to a positioning platform 188.

As shown in FIG. 19, each positioning platform 188 includes a SCARA arm(selective compliance assembly robot arm) 198 coupled to a column 194 bya prismatic joint 196. The prismatic joints 196 are configured totranslate along the column 194 (e.g., along rails 197) to allow each ofthe handles 184 to be translated in the z-direction, providing a firstdegree of freedom. The SCARA arm 198 is configured to allow motion ofthe handle 184 in an x-y plane, providing two additional degrees offreedom.

In some embodiments, one or more load cells are positioned in thecontroller. For example, in some embodiments, a load cell (not shown) ispositioned in the body of each of the gimbals 186. By providing a loadcell, portions of the controller 182 are capable of operating underadmittance control, thereby advantageously reducing the perceivedinertia of the controller while in use. In some embodiments, thepositioning platform 188 is configured for admittance control, while thegimbal 186 is configured for impedance control. In other embodiments,the gimbal 186 is configured for admittance control, while thepositioning platform 188 is configured for impedance control.Accordingly, for some embodiments, the translational or positionaldegrees of freedom of the positioning platform 188 can rely onadmittance control, while the rotational degrees of freedom of thegimbal 186 rely on impedance control.

F. Navigation and Control.

Traditional endoscopy may involve the use of fluoroscopy (e.g., as maybe delivered through a C-arm) and other forms of radiation-based imagingmodalities to provide endoluminal guidance to an operator physician. Incontrast, the robotic systems contemplated by this disclosure canprovide for non-radiation-based navigational and localization means toreduce physician exposure to radiation and reduce the amount ofequipment within the operating room. As used herein, the term“localization” may refer to determining and/or monitoring the positionof objects in a reference coordinate system. Technologies such aspreoperative mapping, computer vision, real-time EM tracking, and robotcommand data may be used individually or in combination to achieve aradiation-free operating environment. In other cases, whereradiation-based imaging modalities are still used, the preoperativemapping, computer vision, real-time EM tracking, and robot command datamay be used individually or in combination to improve upon theinformation obtained solely through radiation-based imaging modalities.

FIG. 20 is a block diagram illustrating a localization system 90 thatestimates a location of one or more elements of the robotic system, suchas the location of the instrument, in accordance to an exampleembodiment. The localization system 90 may be a set of one or morecomputer devices configured to execute one or more instructions. Thecomputer devices may be embodied by a processor (or processors) andcomputer-readable memory in one or more components discussed above. Byway of example and not limitation, the computer devices may be in thetower 30 shown in FIG. 1, the cart 11 shown in FIGS. 1-4, the beds shownin FIGS. 5-14, etc.

As shown in FIG. 20, the localization system 90 may include alocalization module 95 that processes input data 91-94 to generatelocation data 96 for the distal tip of a medical instrument. Thelocation data 96 may be data or logic that represents a location and/ororientation of the distal end of the instrument relative to a frame ofreference. The frame of reference can be a frame of reference relativeto the anatomy of the patient or to a known object, such as an EM fieldgenerator (see discussion below for the EM field generator).

The various input data 91-94 are now described in greater detail.Preoperative mapping may be accomplished through the use of thecollection of low dose CT scans. Preoperative CT scans are reconstructedinto three-dimensional images, which are visualized, e.g. as “slices” ofa cutaway view of the patient's internal anatomy. When analyzed in theaggregate, image-based models for anatomical cavities, spaces andstructures of the patient's anatomy, such as a patient lung network, maybe generated. Techniques such as center-line geometry may be determinedand approximated from the CT images to develop a three-dimensionalvolume of the patient's anatomy, referred to as model data 91 (alsoreferred to as “preoperative model data” when generated using onlypreoperative CT scans). The use of center-line geometry is discussed inU.S. patent application Ser. No. 14/523,760, the contents of which areherein incorporated in its entirety. Network topological models may alsobe derived from the CT-images, and are particularly appropriate forbronchoscopy.

In some embodiments, the instrument may be equipped with a camera toprovide vision data (or image data) 92. The localization module 95 mayprocess the vision data 92 to enable one or more vision-based (orimage-based) location tracking modules or features. For example, thepreoperative model data 91 may be used in conjunction with the visiondata 92 to enable computer vision-based tracking of the medicalinstrument (e.g., an endoscope or an instrument advance through aworking channel of the endoscope). For example, using the preoperativemodel data 91, the robotic system may generate a library of expectedendoscopic images from the model based on the expected path of travel ofthe endoscope, each image linked to a location within the model.Intraoperatively, this library may be referenced by the robotic systemin order to compare real-time images captured at the camera (e.g., acamera at a distal end of the endoscope) to those in the image libraryto assist localization.

Other computer vision-based tracking techniques use feature tracking todetermine motion of the camera, and thus the endoscope. Some features ofthe localization module 95 may identify circular geometries in thepreoperative model data 91 that correspond to anatomical lumens andtrack the change of those geometries to determine which anatomical lumenwas selected, as well as the relative rotational and/or translationalmotion of the camera. Use of a topological map may further enhancevision-based algorithms or techniques.

Optical flow, another computer vision-based technique, may analyze thedisplacement and translation of image pixels in a video sequence in thevision data 92 to infer camera movement. Examples of optical flowtechniques may include motion detection, object segmentationcalculations, luminance, motion compensated encoding, stereo disparitymeasurement, etc. Through the comparison of multiple frames overmultiple iterations, movement and location of the camera (and thus theendoscope) may be determined.

The localization module 95 may use real-time EM tracking to generate areal-time location of the endoscope in a global coordinate system thatmay be registered to the patient's anatomy, represented by thepreoperative model. In EM tracking, an EM sensor (or tracker) comprisingone or more sensor coils embedded in one or more locations andorientations in a medical instrument (e.g., an endoscopic tool) measuresthe variation in the EM field created by one or more static EM fieldgenerators positioned at a known location. The location informationdetected by the EM sensors is stored as EM data 93. The EM fieldgenerator (or transmitter), may be placed close to the patient to createa low intensity magnetic field that the embedded sensor may detect. Themagnetic field induces small currents in the sensor coils of the EMsensor, which may be analyzed to determine the distance and anglebetween the EM sensor and the EM field generator. These distances andorientations may be intraoperatively “registered” to the patient anatomy(e.g., the preoperative model) in order to determine the geometrictransformation that aligns a single location in the coordinate systemwith a position in the preoperative model of the patient's anatomy. Onceregistered, an embedded EM tracker in one or more positions of themedical instrument (e.g., the distal tip of an endoscope) may providereal-time indications of the progression of the medical instrumentthrough the patient's anatomy.

Robotic command and kinematics data 94 may also be used by thelocalization module 95 to provide localization data 96 for the roboticsystem. Device pitch and yaw resulting from articulation commands may bedetermined during preoperative calibration. Intraoperatively, thesecalibration measurements may be used in combination with known insertiondepth information to estimate the position of the instrument.Alternatively, these calculations may be analyzed in combination withEM, vision, and/or topological modeling to estimate the position of themedical instrument within the network.

As FIG. 20 shows, a number of other input data can be used by thelocalization module 95. For example, although not shown in FIG. 20, aninstrument utilizing shape-sensing fiber can provide shape data that thelocalization module 95 can use to determine the location and shape ofthe instrument.

The localization module 95 may use the input data 91-94 incombination(s). In some cases, such a combination may use aprobabilistic approach where the localization module 95 assigns aconfidence weight to the location determined from each of the input data91-94. Thus, where the EM data may not be reliable (as may be the casewhere there is EM interference) the confidence of the locationdetermined by the EM data 93 can be decrease and the localization module95 may rely more heavily on the vision data 92 and/or the roboticcommand and kinematics data 94.

As discussed above, the robotic systems discussed herein may be designedto incorporate a combination of one or more of the technologies above.The robotic system's computer-based control system, based in the tower,bed and/or cart, may store computer program instructions, for example,within a non-transitory computer-readable storage medium such as apersistent magnetic storage drive, solid state drive, or the like, that,upon execution, cause the system to receive and analyze sensor data anduser commands, generate control signals throughout the system, anddisplay the navigational and localization data, such as the position ofthe instrument within the global coordinate system, anatomical map, etc.

2. Introduction to Systems and Methods for Collision Avoidance UsingObject Models

The present disclosure relates to systems and techniques for collisionavoidance using object models. Robotic arms may be used to achieve adesired pose (i.e., position and orientation) of an end effector of amedical tool. In some implementations, the medical tool may include amedical instrument or a camera. In manipulating a robotic arm to achievethe desired end effector pose, there may be a risk that some portion ofthe robotic arm is moved into a pose that would collide with anothernearby object. Examples of objects that may be at risk of collision withthe robotic arm(s) may include, but are not limited to, another roboticarm, object(s) associated with the patient (e.g., a patient introducer,the patient himself/herself, etc.), a platform supporting the patient,medical accessories attached to the platform (e.g., IV bags, tubing,padding, EM generators, etc.), objects associated with the bedside staff(e.g., medical accessories operated by the staff, the bedside staffthemselves, etc.).

During a medical procedure, robotic arms are expected to be safe enoughto operate around other objects in the operating room, including, e.g.,humans, medical equipment, and surgical accessories. For example, staffmust feel safe coming near a robotic arm to change instruments and drapethe system. Staff may interact with one of the robotic armsmid-procedure while other robotic arms in the system are in active use.In another example, an anesthesiologist may set up equipment very nearthe operating sphere or space (e.g., the volume in which the roboticarms can be positioned) during a procedure. Also, medical accessories(e.g., shoulder supports, foot supports, toboggans, leg boards, armboards, fences, stirrups, poles, tissue retractors, etc.) may beattached to the platform or otherwise placed within reach of the roboticarms, and such medical accessories may need to be avoided by the roboticarms during a medical procedure.

Certain robotic medical systems can create a model of the robotic systemwhich can be used for collision detection and avoidance. For example,the system can use the internal kinematics of the robotic system togenerate a 3D model of the platform, arm bars, robot arms, andinstruments. For example, the system may determine the position of eachelement of the robotic system using encoders at each joint in system,each of which generates a signal indicative of the relativeposition/orientation of the two links joined by the corresponding joint.

Using this model, the robotic system is able to detect and avoidcollisions between hardware components (e.g., robotic arms and medicalaccessories) based on their current positions. One challenge of thecollision detection and avoidance modelling system is that the systemmay only include models of components that are attached to the systemduring manufacturing. That is, the size and shape of robotic componentsof the system can be defined at manufacturing, enabling the system totrack the relative positions of each element of the system. However, therobotic arms (or other robotic elements such as the platform) may alsocollide with other objects in the operating room, including medicalaccessories. It would be advantageous for the system to detect and avoidcollisions between the robotic system and other objects in the operatingroom. Thus, aspects of this disclosure relate to systems and methods fordefining and/or detecting objects or areas that the robotic arms are toavoid, in order to maintain distance(s) between the robotic arms and theobjects/areas.

There are a number of different techniques in which the system may beable to define or detect the presence of objects/areas for the roboticarms to avoid. In avoiding the objects, the system may add modelledrepresentations of the objects to the model of the robotic system,enable the system to extend the collision detection and avoidancetechniques to the objects added to the model. By adding the modelledobject/region to the model of the robotic system, the system can controlthe robotic arms to provide at least a minimal set of safety features tomitigate the risk of injury or damage to nearby equipment. In addition,the system can also attempt to optimize robotic arm poses to maintainmaximal distance from objects within the reach of the robotic arms toavoid situations where the robotic safety actions must be employed(e.g., avoidance actions).

A. Pre-Modeled Object Placement

There are a number of defined sets of surgical accessories that can beattached to medical beds, including a platform of the robotic medicalsystems described herein. These surgical accessories can includestirrups, guard rails, and various accessories that clip onto the bed,such as ventilators. FIG. 21 illustrates an example object that can beattached to a platform in accordance with aspects of this disclosure.Specifically, FIG. 21 illustrates an implementation of a pair ofstirrups 202 that can be attached to a rail 212 of a platform 208configured to support a patient 210. Each stirrup 202 may include one ormore adjustable support arms 204 which support the body 206 of thestirrups 202. The stirrups 202 may be configured to support thepatient's 210 legs during a medical procedure.

FIG. 22 illustrates another example object that can be attached to aplatform in accordance with aspects of this disclosure. The surgicalaccessory illustrated in FIG. 22 in an arm board 302 that can beattached to a platform 304. Certain procedures may involve attaching apair of arm boards 302 on opposing sides of the platform 304. The armboards 302 may be configured to support an arm of a patient 306 during amedical procedure.

FIG. 23 illustrates an example robotic medical system 400 having medicalaccessories installed thereon in accordance with aspects of thisdisclosure. The illustrated robotic medical system includes a pluralityof robotic arms 402 and a platform 404. In the illustratedimplementation, a pair of stirrups 406 are attached to the platform 404.As shown in FIG. 23, at least some of the robotic arms 402 may collidewith one of the stirrups 406 when moved into certain poses.

There may be challenges for clinicians to manually mitigate collisionsbetween robotic arms 402 or between one of the robotic arms 402 andmedical accessories such as the stirrups 406. For example, a clinicianmay operate the system 400 with his/her head down in a viewer, which mayprevent the clinician from seeing the robotic arms 402 outside of thepatient's body. Furthermore, each robotic arm 402 may have a pluralityof possible positions that achieve the same medical instrument endeffector pose due to the inclusion of redundant DoFs in the roboticarm(s) 402. Thus, it may not be immediately apparent to the clinicianwhich robotic arm 402 motions outside of the body will result from thecommanded end effector motions inside of the body. The result is thatrobotic arms 402 may collide with each other or with medical accessories(e.g., the stirrups 406) without the clinician being able to predict thecollision.

Thus, in some implementations, the robotic medical system 400 canadvantageously model the robotic arms and medical accessories andprevent collisions between the robotic arms and the medical accessories.For example, the system may prevent the collision by preventing movementof the robotic arm towards the medical accessories. The system may alsoprevent the collision by moving the robotic arm in null space.Additional details regarding detection and avoiding robotic armcollisions are provided in U.S. Provisional Patent Application No.62/906,612, titled “SYSTEMS AND METHODS FOR COLLISION DETECTION ANDAVOIDANCE” filed on Sep. 26, 2019, which can be extended to detectingand avoiding collisions between the robotic arm and medical accessoriesas described herein.

Some attachable surgical accessories are rigid. For such rigid objectsthat do not move during a procedure, the system can update the model ofthe robotic medical system to include a representation of the rigidobject(s) using predefined models for the rigid objects. The predefinedmodels can be stored in memory of the robotic system. Examples ofpredefined models include, but are not limited to: a 3D representationof the rigid object (e.g., a CAD-based model), an approximated modelusing geometric forms (e.g., capsules, cylinders, rectangles, etc.),etc. In certain implementations, the robotic medical system can receiveinput from a user (e.g., via a console or master controller such asconsole 31 of FIG. 1 and/or controller 182 of FIG. 19) that isindicative of one or more objects are within reach of the one or morerobotic arms and allow the user to position the predefined model(s) inthe system model. For example, the system can receive input from theuser that allows the user to select the equipment type that has beenpre-modeled and specify the mounting location (e.g., on a rail of theplatform) on a computer generated image. The console can be configuredto receive input commanding motion of the robotic arms for use during amedical procedure.

FIGS. 24A and 24B illustrate a model of a robotic system approximatedusing a geometric form in accordance with aspects of this disclosure. Inparticular, FIG. 24A illustrates a first perspective view of the roboticsystem model 500 and FIG. 24B illustrates a second perspective view ofthe robotic system model 500. The model 500 includes a plurality oflinks that model a platform 502, adjustable arm support(s) 504, and aplurality of robotic arms 506. The model 500 may include additionallinks that model other components of a robotic system which are notillustrated in detail, such as one or more medical instruments, a base,etc. In some implementations, the model 500 is formed based on a seriesof rigid transformations (e.g., based on the relative size of each link)for each of the links 502-506 and the distance or angle between each ofthe links 502-506 (e.g., the joint angle(s) read from the encoders). Themodel 500 can be generated using, for example, a CAD model drawn foreach link 502-506 with software used to rotate the links 502-506 so thatthe links 502-506 line up with the corresponding joint angles. Thecomputer generated image of the model 500 may look very much like theactual hardware of the robotic system at a given point in time. In someimplementations, the model 500 maintained by the robotic system may notbe stored in a human-viewable format.

In some implementations, the system may generate a human-viewable modeland provide the model to be viewed by a clinician (e.g., in the viewerof the clinician console or the clinician assistant console). In otherimplementations, the model is not viewable by a clinician, but can berunning behind the scenes in the system. The clinician may be capable ofpulling up a view of the model when the model is hidden from view.

Using the model 500 of the robotic system, the system may be able toperform certain actions based on the current configuration of therobotic system. Advantageously, one action that the system can performis detecting when two pieces of hardware are about to collide andprevent the pieces of hardware from colliding.

One aspect of providing for collision detection and avoidance using amodel may involve the system determining how close each link is tocolliding with every other link in the system. There are a number ofdifferent techniques that can be used to determine how close each linkis to each other link. In one implementation, the system can use the CADmodel directly to determine these distances. In another implementation,the system can generate an approximation of the model based on the CADmodel which can be used to speed up computation of the distances betweenlinks. One technique for approximating the CAD model involves generatingan approximation for each link using a geometric form approximation foreach link. In one implementation, the links may be approximated as“capsules.” In other implementations, geometric form(s) used in theapproximation can include using cylinders, rectangles, cuboids, etc. Thesystem can efficiently determine a minimal distance between each capsulein the approximated model using the geometric approximations.

Each link 502-506 of the model 500 can be approximated using one or morecapsules 508 to simplify the calculation of the distances between thelinks. For example, two of the links forming a robotic arm 502 can bemodelled using two capsules 508′ and 508″. The capsules 508′ and 508″overlap and can be moved longitudinally with respect to each other inaccordance with a change in the distance between the correspondinglinks, which is measured using an encoder arranged between the links.Similarly, the platform 502 can be modelled using a plurality ofcapsules 508, which can overlap and may be able to move with respect toeach other to model movement of the platform 508.

As is described in detail below, the system can use the model 500 todetect and/or avoid collisions between a robotic arm 502 and anotherobject in the workspace. In order to detect such a collision, the systemcan update the model 500 to include a model of the object 510. Thesystem can then determine whether a given pose of a robotic arm wouldresult in a collision with the object model 510, which can be used toprevent the collision from occurring. Certain aspects of this disclosurerelate to systems and methods which can be used to update the systemmodel 500 to include one or more object models 510 for use in collisiondetection and avoidance.

FIG. 25 is a flowchart illustrating an example method operable by arobotic system, or component(s) thereof, for updating a model of arobotic medical system to include a representation of one or moreobjects in a workspace in accordance with aspects of this disclosure.For example, certain steps of method 600 illustrated in FIG. 25 may beperformed by processor(s) and/or other component(s) of a medical roboticsystem (e.g., robotically-enabled system 10) or associated system(s).For convenience, the method 600 is described as performed by the“system” in connection with the description of the method 600.

The method 600 begins at block 601. At block 602, the system controlsmovement of one or more robotic arms in a workspace based on inputreceived by a console. For example, with reference to FIG. 23, thesystem 400 can control the robotic arms 402 within a workspace in orderto perform a medical procedure on a patient. In some implementations,the workspace may correspond to the operating room in which the roboticmedical system is located. The workspace may include the 3D volumereachable by the robotic arms 402. The console from which the input isreceive may include, for example, a controller such as the controller182 of FIG. 19.

At block 604, the system receives an indication of one or more objectsare within reach of the one or more robotic arms. As discussed ingreater detail in the implementations provided below, the system mayreceive an input from a user via a console (e.g., via a console such asconsole 31 of FIG. 1) that is indicative of the one or more objects, orthe system may directly detect the presence of the one or more objectsusing sensor(s). At block 606, the system updates the model to include arepresentation of the one or more objects in the workspace. For example,as shown in FIGS. 24A and 24B, the system may include a model of amedical accessory 510 located within the workspace. The system can usethe medical accessory model 510 in order to detect and/or avoidcollisions and thereby prevent collisions between the medical accessoryand the robotic arms. The method 600 ends at block 608.

In implementations where the system receives input indicative of the oneor more objects, the system may display a computer generated image ofthe model 500 and receive the input from a user via the console. Theinput can include commands to move a model of a medical accessory 510 toa location with respect to the model 500 that substantially correspondsto the medical accessory's physical location in the operating room. Forexample, in one implementation, the user can drag and drop arepresentation of a pre-modeled object 510 into the 3D model. AlthoughFIGS. 24A and 24B illustrate the capsule-based model 500, in otherimplementations, the system may hide the simplified model (e.g., thecapsules) and present a more representative 3D model to the user, suchas an image of the robotic medical system 400 illustrated in FIG. 23.

Based on the received user input, the system can update the model 500 toinclude a representation of the added medical accessory 510. The systemcan use the medical accessory model 510 to detect and/or avoidcollisions between any link within the model 500 and the medicalaccessory. Depending on the implementation, the medical accessory model510 can be a representation that closely matches the geometry of themedical accessory or can be a geometrical representation of thepre-modeled object (e.g., a capsule, rectangle, etc.). If the systemlacks a pre-modeled representation of the medical accessory 510, theuser can create a new volume that encompasses the medical accessory(e.g., a box) and place the volume within the model 500.

B. Advanced Sensors for Pre-Modeled Objects

Although a robotic surgical medical can allow a user to add pre-modeledobjects to a model of the robotic medical system, aspects of thisdisclosure also relate to implementations in which the robotic medicalsystem can automatically update the model of the robotic medical systemby adding pre-modeled objects of medical accessories to the model. Forexample, with reference to FIG. 21, the robotic medical system 200 canfurther include one or more sensor(s) (not illustrated) configured todetect when one or more objects (e.g., medical accessories) arepositioned within the reach of the system's the robotic arms. In someimplementations, the sensor(s) can be located on or near the rail 212 ofthe platform 208 in order to detect medical accessories that areattachable to the rail 212. In other implementations, the sensor(s) canbe located on one or more arm supports (e.g., see the arm support 302 ofFIG. 22).

Returning to FIG. 21, the sensor(s) can be configured to detect thepresence of the stirrups 202 when the stirrups are attached to the rail212. In response to a signal from the sensor(s), the system can updatethe model of the robotic medical system to include a modeledrepresentation of the stirrups, for example, by including a medicalaccessory model (e.g., the medical accessory model 510) in a positionindicated by the signal received form the sensor(s). The robotic medicalsystem can then use the updated model to detect and/or avoid collisionsof the robotic arm(s) with the added medical accessories.

As one example, certain medical procedures, such as a laparoscopicprocedure, can involve the use of bed-rail mounted surgical accessories.These accessories may include range from patient positioning devices(like stirrups) to IV poles to liver retractors. Many of these bed-railmounted accessories take up the same volume that is entered by ourrobotic arms (e.g., the stirrups 406 in the robotic medical system 400of FIG. 23). Thus, the robotic medical system 400 can include one ormore sensors that can detect when accessories are attached to theplatform 404.

In some implementations, the sensors may simply detect that a medicalaccessory has been attached to rails (not illustrated) on the platform404. In these implementations, the user may be able to modify the shapeand/or size of a model of a generic medical accessory to better matchthe space occupied by the attached medical accessory. However, in otherembodiments, the sensors can detect the type of attached accessory. Forexample, the sensor may include radio-frequency identification (RFID)sensors configured to read an RFID tag included on the medical accessoryattached to the platform 404. Thus, each accessory can include an RFIDtag that defines the accessory type, and optionally, the size, shape,and/or current configuration of the accessory. The robotic medicalsystem 400 can use the information read from the RFID tag(s) of anyaccessories attached to the platform 404 to update the model of therobotic medical system 400. In other implementations, the sensor(s) caninclude optical sensors (e.g., that read reflective or other visualinformation from the medical accessories), magnetic sensors, inductivesensors, etc.

Implementations that include sensors to automatically update the modelof the robotic medical system have advantages over systems which involvemanually updating the model, since the user is not required to “teach”the robotic medical system where keep-out zones are and the accessoriesdo not need to be placed so far away from the robotic arm workspace asto reduce the likelihood of collisions.

C. Keep-Out Zones for Non Pre-Modeled Objects

Aspects of this disclosure also relate to systems and methods forautomatically updating a robotic medical system model to include objectsthat are non-rigid and/or not pre-modeled. For example, it can bechallenging to design models non-rigid item such as IV bags, tubing,padding, or equipment, that are sufficiently accurate to allow therobotic arms to detect and avoid collisions without creating a large“keep-out zone” for the robotic arms to avoid. The system can allow auser to define one or more 3D regions near the model within which theyplan to place the given piece of equipment, thereby creating a keep-outzone. The system would then restrict the robotic arms from enter thesekeep-out zones, while any equipment would be designed to remain inside.

The medical accessory model 510 of FIGS. 24A and 24B is one example of akeep-out zone that can be placed by a user into the model 500. In theillustrated implementation, the keep-out zone 510 is a rectangular andsymmetrical geometric representation—however, in other implementations,the keep-out zone 510 can be a non-rectangular geometric representation(e.g., square, circular, oval, trapezoidal, etc.). In someimplementations, the keep-out zone 150 can also be non-symmetrical. Incertain implementations, the robotic medical system can include aninterface that allows the user to manually create a unique keep-out zone510 that can be of any shape, including straight and/or curved lines.For example, the interface can allow the user to manually draw aboundary for a keep-out zone via the console. In some implementations,the system may store a database of pre-modeled keep-out zones selectableby the user. The pre-modeled keep-out zones may correspond roughly tothe size and/or shape of objects which are commonly placed in theworkspace during a medical procedure.

FIG. 26 is a flowchart illustrating an example method operable by arobotic system, or component(s) thereof, for preventing movement ofrobotic arm(s) using keep-out zone(s) in accordance with aspects of thisdisclosure. For example, certain steps of method 700 illustrated in FIG.26 may be performed by processor(s) and/or other component(s) of amedical robotic system (e.g., robotically-enabled system 10) orassociated system(s). For convenience, the method 700 is described asperformed by the “system” in connection with the description of themethod 700.

The method 700 begins at block 701. At block 702, the system receives anindication of one or more keep-out zones based on user input received ata console. For example, the user may select a keep-out zone having ashape and size corresponding to an object placed in the workspace of thesystem.

At block 704, the system updates the model to include the one or morekeep-out zones. The system may receive addition user input via theconsole that is indicative of a location in which to place the keep-outzone with respect to the model of the system.

At block 706, the system prevents movement of the one or more roboticarms into the one or more keep-out zones based on the updated model.Thus, the system is able to prevent collisions between the robotic armsand the object by preventing the robotic arms from entering the keep-outzone. The method 700 ends at block 708.

D. Advanced Sensors for Non Pre-Modeled Objects

While the robotic medical system can enable the user to place keep-outzones in the model of the robotic medical system, such keep-out zonesmay be larger than necessary, thereby limiting the working space for therobotic arms as well as the number of possible poses achievable by therobotic arms. Thus, aspects of this disclosure also relate toimplementations of the robotic medical system that include 3D sensors inthe operating room or on the robotic medical system that can be used todetect objects around the robotic medical system during operation. Thesystem can use signals received from one or more types of sensors withinthe environment (e.g., the operating room) to build a dynamic model ofthe environment and/or of objects not included in the robotic medicalsystem model. Example sensors that can be used to detect objects withinthe environment include Lidar, image-based sensors, magnetic sensors,RFID, inductive sensors, and EM sensors. When more than one sensor isused, the system can synthesize the signals received from multiplesensors into the dynamic model of an object being sensed and/or theenvironment.

FIG. 27 illustrates an example dynamic model 800 that can be constructedfrom a Lidar sensor in accordance with aspects of this disclosure. TheLidar sensor can generate the dynamic model 800 using time of flightreadings from projected photons. The system can use the dynamic model800 to detect whether any object(s) are present in the environment andadd the detected object(s) to the robotic medical system model.

FIGS. 28A and 28B illustrate example dynamic models 906 and 920 that canbe constructed from a stereo camera in accordance with aspects of thisdisclosure. With reference to FIG. 28A, the stereo camera can generatethe dynamic model 906 by building a 3D reconstruction from imagedisparity between the two images captured by the stereo camera. Forexample, the image 902 illustrates two images captured from a stereocamera superimposed on each other to illustrate the disparity betweenthe two images. Image 904 provides an example reconstructed view fromthe point of the stereo camera constructed using the image disparityfrom the superimposed image 902 while image 906 provides an example 3Dmodel constructed using the image disparity from the superimposed image902.

FIG. 28B illustrates another example image in which a dynamic model 920including a wire frame 3D model is superimposed on a 2D image capturedby a stereo camera. The dynamic model 920 can be generated using thedisparity between the two images captured by the stereo camera.

In certain implementations, the robotic medical system can include oneor more sensors arranged in the operating room which can be used togenerate a dynamic model of the robotic medical system. The sensors maybe arranged such that at least a portion of the robotic medical systemis within each of the sensor's field of view. Using these sensor(s)(e.g., such as the stereo cameras used to create the dynamic models 906and 920 in FIGS. 28A and 28B), the robotic medical system can generate adynamic model of the robotic system. The robotic medical system canalign the dynamic model with the previously generated model of therobotic medical system (e.g., the model 500 of FIGS. 24A and 24B). Thesystem can generate a transformation from the dynamic model into thesystem model using the alignment between the two models. FIGS. 29A and29B illustrate an example alignment of a dynamic model 1002 to a systemmodel 1004 in accordance with aspects of this disclosure.

In particular, FIG. 29A illustrates the dynamic model 1002 and thesystem model 1004 which are not aligned. The dynamic model 1002 can begenerated using one or more sensors that provide a 3D point cloud (ormesh) representation that corresponds to the object(s) within the fieldof view of the sensor(s). For example, although the dynamic model 1002and the system model 1004 may model substantially the same physicalenvironment (e.g., a robotic arm, the operating room, etc.), the twomodels 1002 and 1004 may not be aligned within a shared coordinatesystem.

The system can align the dynamic model 1002 with the system model 1004by finding a registration that transforms points in the dynamic modelcoordinate system to points in the system model coordinate system. Forexample, in certain implementations, the system can use a derivative ofthe Iterative Closest Point algorithm to align the dynamic model 1002with the system model 1004. However, in other implementations, otheralignment algorithms can be used. FIG. 29B illustrates a visualizationof the two models being aligned 1006. After the alignment transformationis determined, the system can compare points in the dynamic model 1002to points in the system model 1004. The system can identify any pointsfrom the dynamic model 1002 which are un-modeled in the system model1004 as physical obstructions or objects which could potentially collidewith the robotic arms. Thus, the system can use the alignment 1006 tomap these objects into the system model 1004 and either avoid theseobject directly or update the location of both Pre-Model Objects orkeep-out zones in the system model 1004.

E. Corrections to Improve Model Accuracy

Although a number of implementations for modeling objects in the contextof collision avoidance are disclosed herein, there may be situations inwhich the generated object model is not sufficiently accurate. Adding apre-modeled object (e.g., as described above in Section 2.A.) may dependon the user accurately placing the pre-modeled object in a locationwithin the system model corresponding to the object's physical location.The advanced sensors used for pre-modeled objects (e.g., as describedabove in Section 2.B.) have inherent noise, for example, an encoder usedfor detecting the mounting angle might have error of +−0.2 degrees suchthat if a stirrup is 1 meter long then the error at the end point is 3millimeters. A limit switch can have a similar problem in that themounting bracket can be designed to have enough wiggle room to slide theaccessory in and out, resulting in the activation range having +−1 mm ofslop that will directly translate to the collision point. These errorscan also compound and add up to an even larger error. Using keep-outzones (e.g., as described above in Section 2.C.) can depend on the userplaying the objects or equipment accurately within the defined keep-outzone during use in order to remain completely inside this zone duringthe medical procedure. In addition, the use of advanced sensors (e.g.,as described above in Section 2.D.) may have noise and can be occludedand not see parts of the object(s) the sensors are attempting to model.Thus, there may be sources of error and/or inaccuracy for any techniqueused to model objects such that the model may not sufficiently reflectthe real-time state of the world for use in collision detection andavoidance.

The robotic medical system can maintain the safety of each robotic armwith respect to injury or damage during a procedure without reliance onobject models, (e.g., by detecting collisions using force or torquesensors). However, these technique may involve stopping the procedure ifa robotic arm collides with an object that is no longer accuratelyreflected by the corresponding object model. In order to prevent furthercollisions between the robotic arm(s) and the object, the system canautomatically update the object model in response to a robotic armdetecting a collision with the object using a force or torque sensor.For example, the system can use the current position of the robotic armat the time of the collision to expand the closest object model toinclude the collision position, thereby preventing future collisions atthat point in space. In some embodiments, the system may wait forconfirmation from the user (e.g., via a console) prior to updating theobject model to include the collision location. Depending on theimplementation, updates to the object model can involve moving thelocation of the object model with respect to the system model (e.g., forrigid object) and/or increasing the size of a keep-out zone to includethe point of collision.

3. Implementing Systems and Terminology.

Implementations disclosed herein provide systems, methods and apparatusfor collision avoidance using object models.

It should be noted that the terms “couple,” “coupling,” “coupled” orother variations of the word couple as used herein may indicate eitheran indirect connection or a direct connection. For example, if a firstcomponent is “coupled” to a second component, the first component may beeither indirectly connected to the second component via anothercomponent or directly connected to the second component.

The functions for avoiding collisions in robotic arms using objectmodels described herein may be stored as one or more instructions on aprocessor-readable or computer-readable medium. The term“computer-readable medium” refers to any available medium that can beaccessed by a computer or processor. By way of example, and notlimitation, such a medium may comprise random access memory (RAM),read-only memory (ROM), electrically erasable programmable read-onlymemory (EEPROM), flash memory, compact disc read-only memory (CD-ROM) orother optical disk storage, magnetic disk storage or other magneticstorage devices, or any other medium that can be used to store desiredprogram code in the form of instructions or data structures and that canbe accessed by a computer. It should be noted that a computer-readablemedium may be tangible and non-transitory. As used herein, the term“code” may refer to software, instructions, code or data that is/areexecutable by a computing device or processor.

The methods disclosed herein comprise one or more steps or actions forachieving the described method. The method steps and/or actions may beinterchanged with one another without departing from the scope of theclaims. In other words, unless a specific order of steps or actions isrequired for proper operation of the method that is being described, theorder and/or use of specific steps and/or actions may be modifiedwithout departing from the scope of the claims.

As used herein, the term “plurality” denotes two or more. For example, aplurality of components indicates two or more components. The term“determining” encompasses a wide variety of actions and, therefore,“determining” can include calculating, computing, processing, deriving,investigating, looking up (e.g., looking up in a table, a database oranother data structure), ascertaining and the like. Also, “determining”can include receiving (e.g., receiving information), accessing (e.g.,accessing data in a memory) and the like. Also, “determining” caninclude resolving, selecting, choosing, establishing and the like.

The phrase “based on” does not mean “based only on,” unless expresslyspecified otherwise. In other words, the phrase “based on” describesboth “based only on” and “based at least on.”

The previous description of the disclosed implementations is provided toenable any person skilled in the art to make or use the presentinvention. Various modifications to these implementations will bereadily apparent to those skilled in the art, and the generic principlesdefined herein may be applied to other implementations without departingfrom the scope of the invention. For example, it will be appreciatedthat one of ordinary skill in the art will be able to employ a numbercorresponding alternative and equivalent structural details, such asequivalent ways of fastening, mounting, coupling, or engaging toolcomponents, equivalent mechanisms for producing particular actuationmotions, and equivalent mechanisms for delivering electrical energy.Thus, the present invention is not intended to be limited to theimplementations shown herein but is to be accorded the widest scopeconsistent with the principles and novel features disclosed herein.

What is claimed is:
 1. A robotic medical system, comprising: a platform;one or more robotic arms coupled to the platform; a console configuredto receive input commanding motion of the one or more robotic arms; aprocessor; and at least one computer-readable memory in communicationwith the processor and having stored thereon a model of the one or morerobotic arms and computer-executable instructions to cause the processorto: control movement of the one or more robotic arms in a workspacebased on the input received by the console, receive an indication of oneor more objects are within reach of the one or more robotic arms, andupdate the model to include a representation of the one or more objectsin the workspace.
 2. The system of claim 1, wherein thecomputer-executable instructions further cause the processor to: preventa collision between the one or more robotic arms and the one or moreobjects based on the updated model.
 3. The system of claim 1, whereinthe one or more objects are rigid objects.
 4. The system of claim 3,wherein the one or more rigid objects are pre-modeled and stored on thecomputer-readable memory.
 5. The system of claim 3, wherein one or morerigid objects comprise one or more accessories that are attachable tothe platform.
 6. The system of claim 5, wherein the one or moreaccessories comprise at least one of the following: shoulder supports,foot supports, toboggans, leg boards, arm boards, fences, stirrups,poles, and tissue retractors.
 7. The system of claim 1, wherein the oneor more objects are non-rigid objects.
 8. The system of claim 7, whereinthe computer-executable instructions further cause the processor to:update the model to include one or more zones corresponding to thenon-rigid objects within the workspace based on a user input received atthe console.
 9. The system of claim 8, wherein: the one or more zonescomprise keep-out zones in the form of geometric representations, andthe computer-executable instructions further cause the processor toprevent movement of the one or more robotic arms into the keep-outzones.
 10. The system of claim 7, wherein the one or more non-rigidobjects comprise at least one of the following: IV bags, tubing,padding, objects associated with the patient including the patienthimself, and objects associated with the bedside staff including thebedside staff itself.
 11. The system of claim 1, further comprising: oneor more sensors positioned on the platform and configured to detect theone or more objects, wherein the indication of the one or more objectsbeing within reach of the one or more robotic arms is received from theone or more sensors.
 12. The system of claim 11, wherein the platformcomprises a bed including one or more adjustable arms supports.
 13. Thesystem of claim 12, wherein the one or more sensors are positioned alongthe one or more adjustable arms supports.
 14. The system of claim 13,wherein the one or more sensors comprise at least one of: a Lidarsensor, an electromagnetic sensor, and an image-based sensor.
 15. Thesystem of claim 1, wherein each of the one or more robotic arms includesa force sensor configured to detect collisions.
 16. The system of claim1, wherein the computer-executable instructions further cause theprocessor to: receive a signal from one or more sensors positioned inthe workspace, wherein the signal comprises the indication of the one ormore objects being within reach of the one or more robotic arms.
 17. Thesystem of claim 16, wherein the computer-executable instructions furthercause the processor to: generate a dynamic model of the workspace basedon the signal, and compare the dynamic model of the workspace to themodel of the one or more robotic arms, wherein the updating of the modelof the one or more robotic arms is further based on the comparison. 18.The system of claim 16, wherein the one or more sensors comprise atleast one of: a stereo camera, a Lidar sensor, and an image basedsensor.
 19. A robotic medical system, comprising: a platform; one ormore robotic arms coupled to the platform; a console configured toreceive input commanding motion of the one or more robotic arms; aprocessor; and at least one computer-readable memory in communicationwith the processor and having stored thereon a model of the one or morerobotic arms, a database of pre-modeled objects, and computer-executableinstructions to cause the processor to: control movement of one or morerobotic arms based on the input received by the console, receive anindication of one or more pre-modeled objects being within reach of theone or more robotic arms, and update the model to include arepresentation of the one or more pre-modeled objects based on theindication and the database.
 20. The system of claim 19, wherein thecomputer-executable instructions further cause the processor to: preventa collision between the one or more robotic arms and the one or moreobjects based on the updated model.
 21. The system of claim 19, furthercomprising: one or more sensors positioned on the platform andconfigured to detect the one or more objects, wherein the indication ofthe one or more pre-modeled objects being within reach of the one ormore robotic arms are received from the one or more sensors.
 22. Thesystem of claim 21, wherein the platform comprises a bed including oneor more adjustable arms supports.
 23. The system of claim 22, whereinthe one or more sensors are positioned along the one or more adjustablearms supports.
 24. The system of claim 23, wherein the sensors compriseat least one of: a Lidar sensor, an electromagnetic sensor, and animage-based sensor.
 25. A robotic medical system, comprising: aplatform; one or more robotic arms coupled to the platform; a consoleconfigured to receive user input; a processor; and at least onecomputer-readable memory in communication with the processor and havingstored thereon a model of the one or more robotic arms and the platformand computer-executable instructions to cause the processor to: receivean indication of one or more keep-out zones based on the user inputreceived at the console, update the model to include the one or morekeep-out zones, and prevent movement of the one or more robotic armsinto the one or more keep-out zones based on the updated model.
 26. Thesystem of claim 25, wherein the computer-executable instructions furthercause the processor to: prevent a collision between the one or morerobotic arms and the one or more objects based on the updated model. 27.The system of claim 25, wherein: the keep-out zones are pre-modeled, andthe computer-readable memory further has stored thereon a database ofthe pre-modeled keep-out zones.
 28. The system of claim 25, wherein thecomputer-executable instructions further cause the processor to receivea manually drawn boundary for the one or more keep-out zones via theconsole.
 29. A robotic medical system, comprising: a platform; one ormore robotic arms coupled to the platform; one or more sensorspositioned on the platform and configured to detect one or more objectsin a workspace of the robotic arms; a processor; and at least onecomputer-readable memory in communication with the processor and havingstored thereon a model of the one or more robotic arms and the platformand computer-executable instructions to cause the processor to: receivean indication of the one or more objects from the one or more sensors,and update the model, based on the indication, to include the one ormore objects within the workspace.
 30. The system of claim 29, whereinthe computer-executable instructions further cause the processor to:prevent a collision between the one or more robotic arms and the one ormore objects based on the updated model.